Showing Up for Racial Justice: SURJ Chicago Member Profile
This information will help us know how we can best work together. We will not share this information with anyone without your permission.
Name *
What should we call you?
Your answer
What are your preferred pronouns?
Your answer
Email Address *
This is the email we'll use to inform you about all SURJ Chicago information.
Your answer
Phone Number
We will only use this if it's really important and will do our best to notify you first.
Your answer
Based on your interest/expertise, which (if any) of the following committees would you be interested in supporting?
Which (if any) of the following issue teams would you like to work on?
Which of the following neighborhoods/areas best represents where you live? *
This will help us find a good location for our team meetings. ***IMPORTANT: Please select "Other" only if you live outside IL.
What is your zip code? *
This will help us organize outreach to the member of Congress representing you.
Your answer
What is your ward number? (Look it up here: *
This will help us organize outreach to your alderperson. If you live outside Chicago, please enter "Other."
Your answer
Would you be interested in connecting one-on-one with a SURJ member? *
Are you affiliated with any organizations, groups or individuals which would be helpful for us to know about for future collaborations?
Your answer
Do you have access to resources that could be beneficial to our work and if so, what are they? Please note – telling us you have resources doesn’t mean you are required to share them when we ask . . . but we may ask! Resources could include, but are not limited to:
A car which you would use to give rides to meetings or actions - A place to sleep for visiting SURJ members or visiting action participants - A space for SURJ to hold a meeting or event
Your answer
Do you have unique talents/practical skills that could be beneficial to our work? Talents/skills could include, but are not limited to:
Graphic design - social media - child care - legal expertise - fundraising - foreign language proficiency - data analysis
Your answer
How many protests/public actions have you participated in the past 12 months?
How many of those protests/actions were led by People of Color?
Is there anything else you think we should know?
Your answer
How did you hear about us?
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